Role of outpatient physicians in reporting of hematopoietic malignancies for statewide surveillance.

Background: The role of physicians in outpatient setting in reporting of hematopoietic malignancies is not well known.

Objectives: This study described the approaches that Kansas Cancer Registry (KCR) used to ascertain completeness of hematopoietic malignancies reporting at the state level. Our study also examined the role of hematologists, oncologists and primary care physicians (PCP) in outpatient setting in reporting of hematopoietic malignancies.

Methods: KCR engaged all outpatient hematologists, oncologists, and a sample of PCPs who cared for patients in geographic areas where there was limited access to hematologists/oncologists. Cases that met reportable eligibility were identified using the ICD- 9-CM codes from the medical record disease index files and confirmed by reviewing patient medical records. Confirmed cases were then abstracted and sent to the registry. The study focused on 2010 diagnosed Kansan cases.

Results: Of the total 2010 diagnosed cases, 18.7 percent were reported solely by outpatient physicians (17.0 percent reported by outpatient hematologists/ oncologists and 1.7 percent reported by outpatient PCPs only). Fifty-eight percent of polycythemia vera was diagnosed and treated by outpatient hematologists, oncologists, and some PCPs. Using reportable ICD-9-CM codes only for hematopoietic malignancies causes an overestimation of the true reportable hematopoietic malignancies cases.

Conclusion: Outpatient physicians are critical in the scheme of care for hematologic malignancies. Therefore collection of cancer data from these outpatient providers by a well operated statewide registry provides a far more accurate picture of what is really going on with hematopoietic malignancies.